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Spinal Cord Herniation • 10,723 views
This is a case for Prof. Dr. Dillon. It is in press by our neurosurgeons and us, for the use of Duragen. Idiopathic herniation of the thoracic spinal cord: a case report and technique note. U...
Neuro Protocols • 8,067 views
Alisa Gean is doing a great job getting a group together to share and collaborate neuro protocols. This would be a great place from members to share protocols, and open a discussion about the best ima...
Possible SIH with Spinal Subdural Hygroma, What Next? • 6,657 views
[caption id="attachment_602" align="aligncenter" width="407" caption="Sag T1. Tonsils are not particularly low and no sagging of the base of the brain."][/caption] [caption id="attachment_603" alig...
Brachial Plexus MRI Protocol • 5,347 views
BP MRI Protocol Fall is upon us and so is the lecturing season! Like years before, this Fall I will be giving my brachial plexus lecture several times and the most commonly asked question by the au...
Cervical Spine Nomenclature • 5,217 views
The ASNR/ASSR nomenclature document was specific for the lumbar spine. I would be interested in your opinion on the correct terminology for cervical spondylosis: what terms and why. Specifically, t...
Intracranial Hypotension: Advice on Best Treatment • 5,039 views
Middle age female patient diagnosed with Spontaneous intracranial hypotension. Has multiple (approx 23) perineural cysts. Has undergone several blood patches and artificial CSF infusions without rel...
Embolization of Brain Arteriovenous Malformations for Cure • 4,239 views
The editorial comment in the AJNR of Jan 09 by Jayaraman and Cloft is worthy of careful scrutiny, I believe. Although in my personal experience with Onyx and NBCA, final cure rates of brain AVMs from ...
Liver Hemangiomas and Vascular Lesions of the Brain • 4,212 views
[gallery] I have a patient with 15 large liver hemangiomas and two partly calcified lesions in brain. Does anyone know of associated liver hemangiomas and vascular lesions in the brain?
Aunt Mickey (They Look the Same until You Undress Them). Internal Capsule Infarct or Something Else? • 4,144 views
This 30 year old hypertensive female smoker presented with acute onset of right hemiparesis. Her history also included OCP use and dyslipidemia. MRI demonstrated an acute infarct in the posterior limb...
More on DWI of Head and Neck Lesions • 3,979 views
Yesterday I wrote a short comment in the utility of DWI in the evaluation of head and neck lesions. While reading cases in the afternoon I came across a new patient with a retinoblastoma. This pa...
Category Archives: Spine
Tethered Cord in Adult Patients
I am looking for any advice and assistance in the diagnosis minimally tethered cord. That is to say the conus is normally positioned but the cord is the tethered and the patient is symptomatic. One of my neurosurgery colleagues is interested in evaluating patients for the presence or absence of normal motion of the conus via a MR cine technique. Thus far my literature search has not been too helpful, both with respect to validity of diminished conus motion correlating with a clinical tethered cord syndrome, what would constitute normal vs. abnormal in an adult and as to specific pulse … Continue reading >>
Are C1–2 Punctures for Routine Cervical Myelography below the Standard of Care?
Comment on: D.M. Yousem and S.K. Gujar Are C1–2 Punctures for Routine Cervical Myelography below the Standard of Care? AJNR Am J Neuroradiol first published on April 15, 2009 as doi: 10.3174/ajnr.A1594
In an original research article published April 15, 2009, Yousem and Gujar set out to determine the current neruradiologic practices and opinions on the performance of C1-2 punctures for routine cervical myelography. The impetus behind this investigation was a medicolegal case where the plaintiffs attorney argued that the performance of a C1-2 puncture for cervical myelography was below the standard of care.
The authors used a survey instrument … Continue reading >>
Aunt Mickey (They Look the Same until You Undress Them). Colloid Cyst or Something Else?
Aunt Mickeys are alternative diagnoses for “Aunt Minnies”. They represent less common diagnoses, and emphasize the importance of clinical history.
This submission is a 23 year old male patient who became lethargic and somnolent after playing soccer. On physical exam he was somnolent, but arousable with no focal neurologic deficits. An unenhanced CT of the brain initially demonstrated right frontal horn dilatation. A subsequent CT demonstrated bilateral lateral and third ventricular dilatation. Following placement of a ventriculostomy catheter, MRI was obtained and demonstrated a cystic-appearing third ventricular lesion. The lesion was hyperintense on T1WI (Fig 1) and hypointense on T2WI … Continue reading >>
Intracranial Hypotension: Advice on Best Treatment
Middle age female patient diagnosed with Spontaneous intracranial hypotension. Has multiple (approx 23) perineural cysts. Has undergone several blood patches and artificial CSF infusions without relief. Does anyone have any thoughts on other therapies, new techniques, experts in field. Appreciate the input.… Continue reading >>
Spinal Cord Herniation
This is a case for Prof. Dr. Dillon.
It is in press by our neurosurgeons and us, for the use of Duragen.
Idiopathic herniation of the thoracic spinal cord: a case report and technique note.
Ulivieri S.1, Oliveri G.1, Petrini C.1, D’Elia F.2, Cuneo G.L.3, Cerase A.4
Units of 1Neurosurgery, and 4Neuroradiology, “Santa Maria alle Scotte” Hospital, Siena, Italy
2Unit of Radiology, and 3Section of Neuroradiology, Department of Neurology, “San Donato” Hospital, Arezzo, Italy
A 35-year-old man presented with insidiously progressive and disabling pain in … Continue reading >>
Possible SIH with Spinal Subdural Hygroma, What Next?
Young black male with 4 month history of severe headache. HA is positional and improved with laying down and also worse with certain head postitions. His headache was preceded by a few days of neck pain and there was no history of trauma.
Head CT and Brain MR showed tentorial, right convexity and posterior left interhemispheric subdural hygromas. Tonsils not low and no sagging of the base of the brain.
Whole spine MR did not show defnitive epidural CSF to localize leak but did show probable lumbar subdural hygroma distorting the cauda equina. A disc protrusion at C5/6 was noted … Continue reading >>
CT Cisternogram
I would like to know how much intrathecal contrast to inject for a CT cisternogram via a lumbar puncture approach. I am not sure.… Continue reading >>
Using DTI-MRI in Geron’s Phase I Clinical Trial
What do you think about the use of DTI-MRI for tracking the progress of therapy in Geron’s upcoming Phase I clinical trial? DTI measures (transverse and longitudinal diffusivity) in some rodent models of spinal cord injury have shown correlations with myelination and axonal integrity. If the intraspinally injected oligodendrocyte progenitor cells are indeed remyelinating damaged axons, then perhaps tracking patients with non-invasive DTI-MRI could allow the investigators to better assess the outcomes of their intervention?… Continue reading >>